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Colling, ME; Ay, C; Kraemmer, D; Koder, S; Quehenberger, P; Pabinger, I; Posch, F; Gebhart, J.
Lupus anticoagulant test persistence over time and its associations with future thrombotic events.
Blood Adv. 2022; 6(10):2957-2966 Doi: 10.1182/bloodadvances.2021006011 [OPEN ACCESS]
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Posch Florian

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Data on lupus anticoagulant (LA) test stability in patients persistently positive for LA are limited, and its implications on clinical outcomes are lacking. We investigated the rate and predictors of a negative LA test and whether experiencing a negative test affected a patient's risk of future thrombotic events or death in a prospective observational study of persistently LA+ patients. We followed 164 patients (84% women) for a median of 9.2 years and a total of 1438 follow-up visits. During the observation period, 50 thrombotic events (23 arterial and 27 venous events) occurred, and 24 patients died. Forty-six of the patients had at least 1 negative LA test during the observation period, corresponding to a 10-year cumulative incidence of a negative LA test of 28% (95% confidence interval, 20-35). The majority of patients with available follow-up after a negative LA test (n = 41) had at least 1 subsequent positive test for LA (n = 28/41, 68%). Vitamin K antagonist (VKA) treatment at baseline was associated with a negative LA test during follow-up. Using a multistate time-to-event model with multivariable adjustment, a negative LA test had no impact on a patient's prospective risk of thrombosis or mortality. We conclude that a negative LA test during observation cannot be used clinically to stratify a patient's risk for future events.
Find related publications in this database (using NLM MeSH Indexing)
Anticoagulants - therapeutic use
Blood Coagulation Tests - administration & dosage
Female - administration & dosage
Humans - administration & dosage
Lupus Coagulation Inhibitor - administration & dosage
Male - administration & dosage
Prospective Studies - administration & dosage
Thrombosis - etiology

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